10010 SW JOHNSON STREET-2 10010 SW J09NSON S`RCCT
LJ
W
Ir
H
Ln
0
Ln
T
O
n
Ln
Q
O
CD
� f
INSPECTION P-Mc-IE
Citi. of Tigstrd Building Departasmt r
13125 SII Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-41 r
Inspections"_
Footing Plbg. Un;erslab Mach. Rough-in Appr/Sdwlk
Fuund. Plbg. Top Out Gas Line FINAL:
Prat/Bee.m Strucc. San Sewer Framing -Bldg.
Pon./BP,un Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Nech.
Date Requers'.eds �s� � . —Times _ f _AN PN
Address:�� _ r r�i i _ Permit fs
Builders__
THE foLL(YWINO CORRECTIOII/ ARE RZQUIREDs
Inspectors Z is Date: /
APPROVED DISAPPROVED APPROVED SUB.IECT TO AB.,)VR
Call For Reinap.
CITY'OFT10FARD � � tiFCF•,ANI PE RM I-"
CITYOr, ?WARD ;='EPMI'T ##. . . . . . . : MEC91•-0032
COMMUNITY DEVELOPMENT DEPARTMENT ^4140ON
13126&W Hell Blvd.P.O.Box 23397,I*M,Oregon 97�ZU(F03)63"176
DPIF, ISSUED:
I rE ADDREcS"S. . . : 100121 SW JOHNSON PARCEL: 2S102BB-0120;-.'
:3USD I V I`a I ON. . , . : 1'40. T I CARD V I LL.E ADDITION AMEND6 ZONING: R--4. !5
r;LOC:K. . . . . . . . . . q LOT. . . . . . . . . . . . . :SF
.,LASS OF WORK. . :ALT FLOOR FURN. . . . s EVAP COOLERS:
TYPE OF USE. . . . -SF UNIT HEATEW:. . s VEN T FANS. . . :
OCCUPANCY G'RP. . :R3 VENTS W/O APDL: VENT SYSTEMS:
;TORIES. . . . . . ,. . BOILERGI COMPRESSORS HOODS. . . . . . . .
'-IJE L rYp'ES___._._______.._ 0_3 HP. . . . s DOMES. INCIN:
/Wt7D/ / / 5-15 HFA. . . . : COM11L. INCIN:
MAX. INPUT: BTU 15--30 HP. . . . : REPAIR UNIT'S:
1" 1RE- D()MPCRS?. , s 30-50 HP. . . , ,. WOOWETOVF•S. . : 1
(SAS PRF_SSURE. . . : 50+ HP. . ., . s CLU DRYERS. . s
,10. OF UNITS------- AIR HANDLING UNITS OTHER UNITS.
URN ( 100K BTU: (= 10000 cfwls GAS OUTLETS.
7"URN ) -10'eR PTU: 10''!00 cfm:
Remarks : WOODSTCJVE PERMIT
Owner ___.__._____.____. ____._____.________..____ __.________..____._ FF E3 r.
KEN RASMUSSEN type amount by date reapt
10010 SW JOHNSON PGYM $ 15. 23 JLH 02/11/91
PRMT t 14, 150
T'11,3APP OR 97223 sr, T 0 0. 73 /
''hone #s
Contr•a^tor.. ______�__---__._____----------...._.__._._
OWNER/CONTRACTOP
Phone 1#: t 15. 23 faiALM
Peg #. . I --
____..___ RE QUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the F=inal Inspection
Tigard Municipal Code. State of pre. Specialty Codes and all other �'—
applicable laws. All work will be done in accordance with
approved clans. This pewit will Expire it work is not carted —
within 160 days of issuance, or if work is suspended ter morathan 180 days.
e r'm i t t e e vru�.pU Lv
I s s i..t e d By '.
LFA fat- inspect ion -- 619-4175
w
�MRMLWK'WjLwj�wff-TamwoffmMOVIE"I
CITY OF TIGARD RECEIV'T OF PAYMENT RECEIPT NO. 1191-209f-30
CHEDAMOUNI I!.,;. a3
lqAMF- e RWSMUSSEN, REN cAf3l.-J AMOUN'r a 111. 00
Pr;YMENT DATE 021 t I
A D 1)R 1: 10010 (SW JOHNSON r
TIGAPD 9- �`33,- .1iiSDIVISION
pUppr OMOUNT F."AID
f-'A)Rposr. or. PAYMENT VAID [.)F FAYMF-"N'T
14. 50 ST. BUILD PER 0. '73
L)rj(-jr,)FirL)vf-,-- PERMIT
, ^tn w+.w...,.�,ti�IT r.R...r,,.w�y+p - _.R . •r. ., .•: {�'' '"b,..•pl.r^ y,Y.'s g,.. 1.
APPLICATION - STREET IMPROVEMENT/EXCAVATION COPY TO:
ORDINANCE NO 74-14 i I (WHITEFILE
❑ ((YELLOW)W)-I P.
NS
(INSTRUCTIONS ON SEPARATE SHEET) ❑
(PINK) -f}7+i
❑ (BLUE)-APPLICANT
APPROVED
I APPLICATION NO.:
NOT APPROVED ❑ CI I Y OF I IGARD, OREGON FEL AMT.. S
PENDING FEE. PMT, [] (111 N' IIALL RECEIPT 110.:
PENDING SECURITY ( PUBLIC WORKS DEPARTM_N7- BY _— __ DA'rE.' (' /
_ — _ _ Y — _
PENDING AGENCY "OK" ❑ \pplicalioo and I'rogr-sr Record MAINTENANCE BOND F
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED
ANNUAL U
PENDING VARIA":•:.E ❑ EXPIRATION DATE: . rA
_ PERMIT NO.: _L_ ---_ -_ DATE ISSUED: -- ---_�_L ----_ BY: _ - — ---- ---
----
(1) APPLICATION IS HEREBY MADF TO EXCAVATE FOR AND INSTAL)_ _ .;- It 1 rt%T 0
'AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT -
t ---- ;- 1
NAME - � ADDRESS
CONTRACTOR ( ::
ADDRESS PHONE
PLANS BY r �E _
NAME ADDRi.b4 --�� PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ -__' -
DOLL�as
,(
(2) EXCAVATION DATA: FOR OFFICE US
�
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
_ TYPE LENGTH _WIDTH D_EPTN ITEM Q QUANTITY
STREET ---
'N D
INSPI:C-
E TION —
Q
E
ESTIMATED STREET OPENING DATE:—. � _L—_ _ g
EST IMA rED STREET CLOSING DATE: / / E —
(3) SECURITY NO -� SECURITY AMT: E � 1S REET
SURETY CO.: _ FINAL
CER_TIPIED_CHECK Ii _CASH fj.' NOND INSPEC.
(4) PLOT PLAN. INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS / CONDITIONS.
FEATURES; EXCAVATION LOCATION AND EXTENT.
1 I 1 1
I
URB
1 I I I
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE RCOUIRED SECURITIES, TO COMPLY WITH ALL PEPrINENT LAWS AND
C.-NSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WOOK, AND TO SAVE 14ARMLF.SS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FrOM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE 1
DATE
ar as
CITY OF TIGARD MECHANICAL PERMIT Receipt #
Permit#
Description --
Table 3A Mechanical Cod_a OTY PRICE AMT
City of Tigard Co.
de
S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 --—
Tigard, OR 97225 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BTU w _
1) incl.ducts&vents 6.00
^Furnace 100,000 BTU
2) incl.ducts&vents 7.5U-
Name of Development Floor Furnace
3) incl.vent 6.00
Job Address Suspended heater,wall heator
Address 4) or floor mounted heater 6.00
Tax Lol i — Map No -- Vent not incl.in '
5) 3.00
Lot Block Subdivision appliance permit _
Name(or name of business) Repair of heating,refr ig.,
6) cooling,absorption unit 6.00
Mailir g Address — Phone Boller or comp to 3 HP
Owner 7) absorp.unit to 100,000 BTU 6.00
city/state
Zip — Boiler or comp to 3 HP-15 HP
8) _absorp.unit to 500,000 BTU i 1'00
Name Boiler or comp 15-30 HP -
9) 15.00
absorp.unit' -1 million
h
Mailing Address �— Phone 1 Q) Boiler or comp to 30-50 HP 22,50
absorp,unit 1 -1.75 million
Contractorcn�state Zip Boiler or comp to 50 HP
11) absorp,unit 1,750,000 BTU 31.50
State Registration No. - City Bus,Tax No 12) Air handling unit to — 4 50 ----__
10,000 CFM
I hereby acknowledge that I have road this application that the information given is 13) Air handling unit 7.50 10,000 CFM +
correct,that I am the owner or authorized agent of the owner,that plans submitted are in
compliance with Stats laws,that I am registered with the State BuildersBoard,that thei4) Non portable 4.50
number given is cormcl (If exempt from State registration please give reason below) evaporate cooler
15) Vent fan connected
to a single duct 3.00
16
) Ventilation system not
included in appliance permit 4.50
Hood served by T
17) mechanical exhaust 4.50
Signature(owner or agent) + Date ) Domestic typ!?
-------- — -----
incinerator 7.50
Describe work n addition LAY alteration I 1 repair I 1
to be done residential Lj non-residential 1 1 19) Commercial or Industrial
type incinerator 90.00
Existing use of __—
building or properly 2(, Other i.e.,woodstove,water 4.50
heater,solar,clothes dryers,etc.
Proposed usra of —_ � _.-
building or property-- - 21) Gas piping one to four outlets 2.00 2
Type of fuel-- oil I I natural gas L.l LPG I 1 electric f I - --
-' 22) More than 4-per outlet
NOTICE — SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON - ---- --- -- 1'
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 i 4%SURCHARGE r�6
DAYS, OR IF CONSTRUCTION OR WORK: IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER ---- -- -
WORK IS COMMENCED. TOTAL
_7
Special Conditions
--- Date issued _ ,t �' by
INSPECTION NOTICE
City of -figard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested 3 Time .A.M. _P.M.
Address ���� -s-�c�i�'ivSy1. Permit
Owner_ ---
Lot #._
"i he following Building Code deficiencies are required to be corrected:
__---- ----_- rte-
Presented to f LI Approved
Inspector ..L I Disapproved
Date c S
CALI, EINSPEC77ON
WS
n] NO
.-.,,...,ter.-..n^*.�•.y.5.......w.r,mn.-..mu..w...,.,....«..+rw................,....�.- ..... ............... �i.. .....
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 9', `23
Phone 639-4171
Address.____------- --- 1' , r _��� c?..
.__ Permit
Type of Inspection
The following Building Code deficiencies are required bn be corrected:
.,
Presented toInspector
Dete — _—
(ALL FOR RF.IA
❑ YES ❑ No
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address Permit
Type of Inspection
The following Building Code deficiencies are required to be corrected:
Presented to Inspector
Mtn
C4LL FOR RFIMSPEC170W
El YF'8 FJ NO
BUILDING PERMIT APPLICATION TIGARD DATE_-_ 7/2E/ 19 1`n 3307
THE UNDERSIGNED HEREBY APPLIES FOR A PERM i FORTH E WORK HEREIN INDICATED BUILDER PHONE -'O''�_a 3
OR AS SHOWN AND APPROVED iN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE }'7
t6X LOT NO..1Ln1 I—Rb _
OWNER r. `a l.l:i: JOB ADDRESS 1.0IJ1.1.; t Juhnaon Street
ARCHITECT
ENGINEER
BUILDER saamt; _ _ ADDRESS 9685 SU Johnson #J DESIGNER
STRUCTURE 41 NEW EJ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE l ) COMM ❑ EDUCATIONAL ❑ GOV'T Cl RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY -----LAND USE ZONE _F' BLDG.TYPE JN —FIRE ZONE__A__PLAN CHECK BY Cll�h HEAT___?
uualling u ettaahed Saye. 3 Bedrooms 1 bath. _
`IfifiECTIpfV SHEET ATTACHED.
SEWER PERMIT# 21984 - J750•00 _garo�Ie `, 0 _eLTI. I �•
OCC-LOAD FLOOR LOAD 40 HEIGHT 13 NO.STORIES 1 AREA 1412 NO.BEDROOMS 5 VALU111:60. 100-
BUILDING DEPARTMENT SET BACKS FRONT 30 REAR ?7 LEFT SIDE 6 y RIGHT SIDE b l -
Permlt +?'207•nn _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
m REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT T4E
Plan Check 107. 5r) WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal _ • �3O RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPAIIATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Slate Tax 4 4nn.UO
SDC—
Total .7d PDCN T ", I0 O.OO APPLICANT OR AGENT
— --
B
Approved
Receipt No. G k I5 G — -----PHONNEE
A9---�+�_��---
t � G1R t Ian
_DATE INSP. TYPE INSPECTIONREMARKS PLUMBING` DATa
�— —
Jt,4 7 00, / y _ -_ Contractor I
r� A
00
%/r► Permit No. V7
/��M �y_dI►t.L Rough-in --
Fixture
.�3 9 r `�s•�f Final
/-30;D' �� ► HEATING --
,tv N Contractor
-- - ----- Permit No. * O
Gas br Oil
Rough-in
—--- Final
SEWER
Final Final
DRIVEWAY
v Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
6 _ 1 _ Approach -- --
BLDG.D T. FINAL TIiMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
n Zoning Final
L�=�t�G�see<a CS�b-rtie� •�,��c-�- /`..e ss...,r:��.5
1
r
a
i
f
k
i`
F j
1
i